Rapid Response Team

1
Rapid Response Team

• Patty Gessner, RN
• Guy Dugan, MD, FCCP
• Carlotta M. Rinke MD, FACP, MBA
• Alexian Brothers Medical Center

2
About us

• Alexian Brothers Medical Center
• Located in Elk Grove Village Illinois
• Non-teaching community hospital
• 370 bed
• Level II Trauma
• 32 total ICU beds

3
Evolution of a Concept

• Concept of RRT originated in 1990
• Shown to decrease mortality

(Buist, M. et al BMJ 2002)
4
Our Program

• Proposal developed in June 2004
• Approval achieved through medical and nursing
  departmental meetings
• Awareness through attendance at the town hall
  meetings, flyers, and through the efforts of key
  support personnel
• Start date October 1st 2004

5
Details of the Team

• One person to carry the team phone
• Monday through Friday 0700-1900
• Non-direct ICU clinician
• Immediate access to Intensivist and Respiratory
  Therapy
• Nights and weekends
• Intensivist

6
Activation of the Team

• Staff recognize crises and call RRT phone
• Criteria to call
• Respiratory distress
• Acute changes in heart rate or blood pressure
• Acute changes in mental status
• Uneasy feeling

(Kleinpell, R.M. Nursing Spectrum 2002)
7
Data

• The next slides represent data collected
• 59 calls logged between October 2004 through
  January 2005

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RRT Reason for Call
9
RRT By Nursing Unit
10
RRT Time of Call
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RRT Outcome
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Keys Findings and Results

• 5 codes were averted
• Avoided transfer to ICU in 36 of cases
• Average time spent on call was 39 minutes
• Peak call times have lead us to further
  investigation
• Positive feedback from staff, physicians, and
  families

13
Next Steps

• Reduce the number of codes that occur outside
  critical care
• Increase awareness of program on night shift
• Retrospective examination of cases during the
  peak times

14
Challenges and Lessons Learned

• Acceptance of Attending Physicians
• Use standing protocols
• Keep attending informed
• Difficulties with the phone
• Education
• Back up pager
• Ongoing staff awareness
• Signs
• Presentations at unit meetings
• Information both